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Updated: Jun 1, 2026
08:56
Tissue-Engineered Graft for Circumferential Esophageal Reconstruction in Rats
Published on: February 10, 2020
Esophageal reconstruction using a pedicled jejunum with microvascular augmentation
Takushi Yasuda1, Hitoshi Shiozaki
1Department of Surgery, School of Medicine, Kinki University, Osaka-Sayama, Japan. tyasuda@surg.med.kindai.ac.jp
Summary
Pedicled jejunal reconstruction for esophageal replacement offers advantages over colon grafts but initially had high complication rates. Advances in microsurgery have significantly reduced these risks, making it a safer option.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Esophageal Surgery
Background:
- Pedicled colon segments are standard for esophageal reconstruction when the stomach is unavailable.
- Pedicled jejunal grafts have emerged as an alternative, but early techniques faced significant challenges.
Purpose of the Study:
- To evaluate the evolution and current safety of pedicled jejunal reconstruction in esophageal surgery.
- To compare the outcomes of jejunal reconstruction with traditional colon grafts.
Main Methods:
- Review of historical and recent surgical techniques for pedicled jejunal grafts.
- Analysis of complication rates, including gangrene, mortality, and anastomotic leakage.
- Comparison of functional outcomes between jejunal and colon grafts.
Main Results:
- Initial jejunal reconstruction had high rates of gangrene (22.2%) and mortality (46.5%) due to compromised jejunal circulation.
- Microsurgical advancements, including microvascular anastomosis, have reduced gangrene and mortality to near zero.
- Jejunal grafts offer benefits like lower intrinsic disease incidence and improved food transport but have a notable anastomotic leakage rate (11.1%–19.2%).
Conclusions:
- Pedicled jejunal reconstruction, enhanced by microsurgery, is now a safe and effective esophageal substitute.
- Further improvements in surgical techniques are needed to address the persistent issue of anastomotic leakage.
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